Pharmacotherapy has been shown to change the natural history of HFrEF. HFpEF however, has been identified as major public health issue and to date, the etiology, diagnosis, characterization and treatment has remained challenging. Goals of HF therapy include improving survival and reducing morbidity such as hospitalizations and symptoms, while improving functional capacity and quality of life. Figure 4 outlines a therapeutic approach to patients with HFrEF that is considered optimal medical therapy and defined as guideline-directed medical therapy (GDMT) throughout this section. The evidence-based medications and doses of GDMT are shown in Table 11.